Longstanding rhinolith leading to anatomical alterations of the ipsilateral inferior nasal meatus and turbinate

Abstract

Rhinoliths consist of a central nidus with calcification resulting in calcareous concretions within the nasal cavity. They are uncommon in the literature despite a propensity particularly in children to insert foreign bodies into their nose and ears. We present the case of a 62-year-old woman with a longstanding undetected rhinolith with mild uncharacteristic symptoms. Radiographic examination revealed anatomical alteration of the inferior turbinate that was attributed to the long presence of the rhinolith in the nasal cavity. The management of the rhinolith and a review of the literature are presented.

Figure 1

(A,B) Endoscopic view of the rhinolith on the floor of the left nasal cavity before and after mobilisation. (C) Left nasal cavity after removal of the rhinolith. Marked atrophy of the head (bold arrow) and anterior third of the inferior turbinate is visible. (D) Mild polypoid degeneration of the turbinate mucosa posterior to the rhinolith (slim arrow) can be seen. IT, inferior turbinate; S, septum.

Figure 2

Axial CT image (A) shows a radiopaque object with a radiolucent core (anteroposterior, sagittal dimensions were 9×11 mm) in the anterior third of the left nasal cavity. Atrophy of mucosa and os turbinalis is visible. Coronal CT views of the anterior (B) and middle (C) third of the inferior nasal meatus show the height difference between the left (2.8 cm/1.8 cm) and right (1.7 cm/1.2 cm) meatus. No other anatomical alterations were detected.